Professor Sylvie Freeman DPhil, MBChB, MRCP, FRCPath

• Certificate of Completion of Specialist Training (Clinical Haematology), 2003
• FRCPath (Haematology), 2002
• DPhil, University of Oxford, 1996
• MRCP (London), 1990
• MBChB (Hons), University of Birmingham, 1987

Professor Sylvie Freeman’s clinical interests are in the management of acute myeloid leukaemia and myelodysplasia and diagnostics of haematological malignancies. This with her background in myeloid research led to her laboratory translation research focus on predicting treatment resistance in these myeloid malignancies.

During Professor Freeman's clinical specialist haematology training at Oxford, she completed a MRC funded DPhil followed by a MRC Clinician Scientist award. She had a clinical attachment at UCL and finished her clinical training in Bristol before being appointed in 2000 as a clinical academic at Birmingham University and honorary consultant at University Hospitals Birmingham NHS Foundation Trust. She is a member of the NCRI AML working party, the European LeukemiaNet AMLMRD Working Group and more recently the Laboratory and Diagnostic subcommittee/ International Consortium on Acute Leukemia Committee (American Society of Hematology).

NCRI AML trials are in effect a national care plan for AML therapy within the NHS. Her laboratory work in the framework of a national NCRI clinical trials collaboration addresses a key question; whether relapse prediction in AML and myelodsyplasia could be improved by sensitive detection of leukemia-specific markers. She has developed and implemented immunophenotypic assays to evaluate and monitor AML during chemotherapy and allogeneic stem cell transplantation, recently extending this to novel assays tracking leukemic stem cell enriched populations with national /international collaborators. Under her leadership the Birmingham University Clinical Immunology Service has established an international reputation for flow cytometric AML monitoring, acting as the hub reference laboratory in the UK. Sylvie has a part time role at the WHIMM in Oxford that will build on joint expertise for developing AML monitoring assays. Collaborations with the molecular expertise at KCL, Cambridge and international colleagues are critical to optimise ‘fit for purpose’ precision assays that will best inform treatment of AML including for novel therapies.

Teaching programmes

• MBChB - Foundations of Medical and Science Practice 3 Immunology and Haematology course
• BMedSci  
• MPharm 

The heterogeneity of AML in terms of both disease biology and patient-specific clinical factors necessitates advances in personalised risk stratification to improve outcomes with present and future therapies. Although not a common malignancy, treatment of patients with AML is disproportionately expensive particularly if patients have treatment intensified by stem cell transplantation. There are therefore major economic as well clinical benefits to be gained by better selection of patient-appropriate targeted therapies.

Laboratory work in the framework of a national NCRI clinical trials collaboration addresses a key question; whether relapse prediction in AML and high risk myelodsyplasia could be improved by sensitive detection of leukemia-specific markers.

The first study of MRD in older AML patients (NCRI AML16, CRUK funded) generated data (Freeman et al JCO 2013) that underpins MRD-directed therapy in older patients (NCRI AML18 trial). The collaborative analysis of younger patients in AML17 (NIHR funded, Prof Grimwade King’s College, London)) has produced important data on the prognostic relevance of molecular MRD (Ivey et al NEJM 2016) as well as flow cytometric MRD (Freeman et al JCO 2018) that are now being implemented for MRD directed therapy in the younger AML patients (NCRI AML19. In addition to flow cytometric MRD monitoring by standard leukemic-aberrant-immunophenotypes there is a collaborative focus on developing novel assays tracking leukemic-stem-cell-enriched populations, mass cytometry deep phenotyping and combining genetic profiling with flow cytometric data. In collaboration with Prof Craddock / Prof Vyas (Oxford), the potential of LSC tracking in parallel with conventional MFC MRD pre and post allogeneic transplantation was established (Bradbury et al, Leukemia 2015) and is part of a prospective randomised RIC-transplantation programme (FIGARO trial, BloodWise funded). The group are also testing a simple assay that might identify prior to treatment AML patients unlikely to respond to standard intensive chemotherapy by blood frequency of stem-cell-like blasts (BloodWise funded, collaboration with Prof Russell/Prof Hills for NCRI AML18) and evaluate expression of cell surface molecules that are targets for established and novel antibody directed AML therapy (Khan et al Leukemia 2017)

Collaborations

National

• Professor Russell (Nottingham / Guy’s Hospital), Dr Dillon (KCL), Professor Hills (Oxford / Cardiff), Professor Vyas (Oxford), Professor Huntly (Cambridge) plus other members of UK AML working group, Paul Virgo (Bristol).

• Previously Professor Grimwade (KCL) and Professor Burnett (Cardiff).

International

• European LeukemiaNet
• Cloos/ Schuurhuis/ Ossenkopele (VU, HOVON group, Netherlands)
• Plesa (Lyon), Roumier (Lille), (leads for AML flow cytometric MRD for French AML ALFA group)
• Hourigan, (NIH National Heart, Lung and Blood Institute, Bethedsa, USA)
• Pappaemannuil (Memorial Sloan Kettering Cancer Center, USA).

College/UHB

• Professor Craddock

• Member of the UK NCRI Acute Myeloid Leukaemia Working Party
• Member of Trial Management Group of NCRI AML Trials (AML18, AML19, FIGARO)
• Member of the European LeukemiaNet Acute Myeloid Leukemia MRD Working Group
• Member of the Laboratory and Diagnostic subcommittee /International Consortium on Acute Leukemia Committee (American Society of Hematology).
• Honorary Consultant University Hospitals Birmingham NHS Foundation Trust
• Honorary contract WHIMM, Oxford University